title: Microperimetry, fundus autofluorescence, and retinal layer changes in progressing geographic atrophy.
abstract: OBJECTIVE
  To analyze correlation among microperimetry, inner and outer retinal layers, and fundus autofluorescence (FAF) changes in eyes with progressing geographic atrophy (GA) secondary to age-related macular degeneration.
  
  
  METHODS
  Microperimetry, spectral-domain optical coherence tomography (SD-OCT), standard short-wavelength FAF (SW-FAF), and near-infrared-wavelength FAF (NIR-FAF) were performed for all patients at both baseline and follow-up visits. FAF pattern, integrity of photoreceptor inner segment/outer segment (IS/OS) junction, total retinal thickness (RT), inner retinal layers (IRL), and outer retinal layers (ORL) thickness changes of every microperimetry extrafoveal tested point were analyzed.
  
  
  RESULTS
  A total of 366 microperimetry tested points were analyzed (6 patients, 7 eyes). Mean retinal sensitivity significantly decreased (p = 0.0149), and the percentage of dense scotomas significantly increased (p = 0.0125). Mean RT and mean ORL thickness significantly decreased (both p < 0.0001). Mean IRL thickness significantly increased (p = 0.0001). The decrease of ORL thickness was inversely correlated to the IRL thinning (rho = -0.710). FAF pattern at baseline was correlated to RT and ORL thickness (both p < 0.0001) and was significantly correlated to the risk to evolve to dense scotoma during follow-up (p = 0.0001 at SW-FAF, p < 0.0001 at NIR-FAF). Tested points showing at baseline the loss of photoreceptor IS/OS junction had a greater risk for evolving to dense scotoma compared with those with intact photoreceptor IS/OS junction (odds ratio 3.56, 95% CI 2.41-5.27).
  
  
  CONCLUSIONS
  Retinal sensitivity changes are correlated to IRL and ORL thickness changes, and to photoreceptor IS/OS junction integrity. FAF patterns remain a relevant factor in predicting GA evolution. Microperimetry, SW-FAF and NIR-FAF, and SD-OCT should be combined to obtain adequate morphologic and functional prospective information.
authors.affiliation: Department of Ophthalmology, University of Padova, Padova.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Pilotto
authors.forename: Elisa
authors.initials: E
authors.lastname: Benetti
authors.forename: Enrica
authors.initials: E
authors.lastname: Convento
authors.forename: Francesca
authors.initials: F
authors.lastname: Guidolin
authors.forename: Evelyn
authors.initials: E
authors.lastname: Longhin
authors.forename: Raffaele
authors.initials: R
authors.lastname: Parrozzani
authors.forename: Edoardo
authors.initials: E
authors.lastname: Midena
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods*; D057092:Geographic Atrophy / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D008268:Macular Degeneration / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D012160:Retina / Q000503:physiopathology*; D055211:Retinal Photoreceptor Cell Inner Segment / Q000473:pathology*; D055214:Retinal Photoreceptor Cell Outer Segment / Q000473:pathology*; D013223:Statistics as Topic; D041623:Tomography, Optical Coherence / Q000379:methods*; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests / Q000379:methods*; D014794:Visual Fields